Knowledge and Attitudes as Influencing Factors For Adopting Health Care Technology Among Medical Students in Germany

Telemedicine services are increasingly being tested in pilot projects and integrated into standard care. One of the primary reasons for the failure of such innovation processes is the lack of user acceptance. This will soon affect doctors who will have to use telemedicine but will be unfamiliar with it.  Knowledge and attitudes prevalent amongst medical students in Germany were surveyed and their perceived relevance for medical practice analysed. METHODS: In an online-based approach 524 medical students in Germany were interviewed. The participants (63.6% women, average age 25 years) were randomly selected. Correlations were tested within a linear regression model between the expressed expectations (independent variables) and the perceived importance of telemedicine for their future medical practice (dependent variable).RESULTS: The students surveyed showed great interest in telemedicine. The increasing mechanisation of care processes is generally viewed positively. The sooner medical students develop a positive attitude towards the impact of telemedicine for a given medical treatment (p=0.006), diagnostic and therapeutic efficiency (p=0.008) and public health-related costs (p=0.002), the more they tend to assign technology a high value for their future professional practice. There is, however, a lack of information about the potential use of technology. CONCLUSIONS: There is an urgent need to eliminate knowledge deficits in order to develop treatment-related telemedicine services. This would include more professional publications and furthering education, as well as training more physicians in telemedicine in Germany

Emotional self-regulation of individuals with autism spectrum disorders: smartwatches for monitoring and interaction

In this paper, we analyze the needs of individuals with Autism Spectrum Disorders (ASD) to have a pervasive, feasible and non-stigmatizing form of assistance in their emotional self-regulation, in order to ease certain behavioral issues that undermine their mental health throughout their life. We argue the potential of recent widespread wearables, and more specifically smartwatches, to achieve this goal. Then, a smartwatch system that implements a wide range of self-regulation strategies and infers outburst patterns from physiological signals and movement is presented, along with an authoring tool for smartphones that is to be used by caregivers or family members to create and edit these strategies, in an adaptive way. We conducted an intensive experiment with two individuals with ASD who showed varied, representative behavioral responses to their emotional dysregulation. Both users were able to employ effective, customized emotional self-regulation strategies by means of the system, recovering from the majority of mild stress episodes and temper tantrums experienced in the nine days of experiment in their classroomThis work has been partially funded by the projects “e-Training y e-Coaching para la integración socio—laboral” (TIN2013-44586-R) and “eMadrid-CM: Investigación y Desarrollo de Tecnologías Educativas en la Comunidad de Madrid” (S2013/ICE-2715). It has been also funded by Fundación Orange during the early stages of the project “Tic-Tac-TEA: Sistema de asistencia para la autorregulación emocional en momentos de crisis para personas con TEA mediante smartwatches

Sex and gender differences in technology needs and preferences among informal caregivers of persons with dementia

Background: Dementia is a major public health concern associated with significant caregiver demands and there are technologies available to assist with caregiving. However, there is a paucity of information on caregiver needs and preferences for these technologies, particularly from a sex and gender perspective. To address this gap in research, the objectives of this study are to examine (1) the knowledge of technology, (2) perceived usefulness of technology, (3) feature preferences when installing and using technology and (4) sex and gender influences on technology needs and preferences among family caregivers of persons with dementia (PWD) across North America. Methods: A secondary analysis was conducted on an existing cross-sectional survey with family caregivers of PWDs. Respondents were recruited through the Alzheimer Society of Canada, the Victorian Order of Nurses and Adult Day Programs and other Canadian health care provision institutes. Descriptive statistics, bivariate and multivariate analyses were used to describe the study sample, uncover differences between male and female caregivers and examine sex and gender influences on caregivers’ technology needs and preferences. Results: A total of 381 eligible responses were received over a nine-month data collection period. The majority of respondents did not know much about and never used any technologies to assist with caregiving. “Being easy to install”, “easy to learn how to use” and “cost” were identified as the most important features when purchasing and setting up technology, while “reliability” was identified as the most important feature when using technology. Most respondents were willing to pay up to $500 to acquire individual technologies. Controlling for other socio-demographic variables, female respondents were more likely to have some or more knowledge about technology for caregiving while male respondents were more willing to pay higher amounts for these technologies compared to their female counterparts

Recovering breast cancer patients’ views about the use of in-vivo biosensors to personalise radiotherapy treatment

This report covers an important component of the EPSRC-funded IMPACT project that is developing implantable biosensors to monitor the tumour micro-environment so as to target X-ray dosage to hypoxic areas, thereby maximising the effectiveness of the treatment (www.eng.ed.ac.uk/impact). This qualitative study explored the views of breast cancer patients about implanted biosensors through a series of semi-structured interviews with 32 women who had successfully completed a course of treatment. The aim was both to consider detailed aspects of patients’ willingness to benefit from a possible technological enhancement of treatment and also to understand their views on the challenges of living with what that treatment might mean

Exposing Privacy Concerns in mHealth Data Sharing

Mobile health (mHealth) has become important in the field of healthcare information technology, as patients begin to use mobile devices to record their daily activities and vital signs. These devices can record personal health information even outside the hospital setting, while the patients are at home or at their workplace. However, the devices might record sensitive information that might not be relevant for medical purposes and in some cases may be misused. Patients need expressive privacy controls so that they can trade potential health benefits of the technology with the privacy risks. To provide such privacy controls, it is important to understand what patients feel are the benefits and risks associated with the technology and what controls they want over the information. We conducted focus groups to understand the privacy concerns that patients have when they use mHealth devices. We conducted a user study to understand how willing patients are to share their personal health information that was collected using an mHealth device. To the best of our knowledge, ours is the first study that explores users\u27 privacy concerns by giving them the opportunity to actually share the information collected about them using mHealth devices. We found that patients tend to share more information with third parties than the public and prefer to keep certain information from their family and friends. Finally, based on these discoveries, we propose some guidelines to developing defaults for sharing settings in mHealth systems

DEVELOPMENT OF A CUSTOMIZED ELECTRONIC REMINDER TO FACILITATE POWERED SEATING FUNCTION USAGE AND COMPLIANCE WITH CLINICAL RECOMMENDATIONS: DESIGN PROCESS AND CLINICAL EFFICACY

Compliance with clinical guidance on powered seating function (PSF) usage is very low among individuals who use electric powered wheelchairs (EPWs), leading to high risks for secondary complications, with potentially devastating health consequences, and drastically reduced quality of life. The purposes of this research project were to 1) develop a pervasive and persuasive reminder system, Virtual Seating Coach (VSC), to facilitate appropriate use of PSFs for health management following clinical recommendations; and 2) evaluate the efficacy of VSC on facilitating PSF usage and improving compliance with clinical recommendations. Survey studies, in-lab tests, and a pilot test study were conducted to ensure that users' feedback was incorporated in the development of the VSC. The research team gradually improved and refined the VSC in the development process. A randomized group study was conducted to evaluate the efficacy of the VSC. Participants used study EPWs equipped with the VSC for 8 weeks, including 2 weeks of baseline data collection and 6 weeks of intervention by receiving an educational program or the VSC in conjunction with the educational program. The educational program included providing educational materials in video, pamphlet, and flash cards formats, and recurrent meetings with a clinician once every two weeks to discuss PSF usage. Twenty six individuals participated in the study, and sixteen of them completed the study protocol. The study results showed that the intervention of the VSC in conjunction with the educational program increased the compliance rate around 40%, while the intervention of the educational program alone increased the compliance rate around 18% compared to the baseline period. Providing timely cues, accessible instructions and feedback were critical to facilitate a desired health behavior. Participants had large variability in the directions and strength of correlations between PSF usage and measures of quality of life (QoL). Gender, experience in EPW and PSF usage, and ambulatory ability may affect the relationships between PSF usage and QoL. More studies are needed to determine how to interpret the measures of QoL as outcome measurements for the effect of PSF usage

Effekte und Nutzen altersgerechter Assistenzsysteme (ENAS): Leitfaden für die Planung und Durchführung von Studien zur Evaluation neuer technischer Assistenzsysteme in Forschungs- und Entwicklungsprojekten

Dieser Leitfaden entstand im Rahmen des Projektes ENAS („Effekte und Nutzen altersgerechter Assistenzsysteme – praktikable Vorgehensmodelle, Evaluationsmethoden und Werkzeuge“), welches durch das Bundesministerium für Bildung und Forschung (BMBF) gefördert wurde. Dieser Leitfaden soll Akteuren in konkreten Forschungs- und Entwicklungsprojekten im Bereich der Mensch-Technik-Interaktion zur Unterstützung von Menschen mit Hilfsbedarf eine Orientierungshilfe zur Verfügung stellen

Technikkompetenz, Nutzerpräferenzen und Rehabilitationsmotivation bei Patienten mit Fazialisparese: Aspekte für die Entwicklung eines emotionssensitiven Trainingssystems

In den letzten Jahren wurden verschiedene Programme zum digitalen Training der Gesichtsmuskulatur für Patienten mit Fazialisparese entwickelt. Gerade für Patienten mit chronischer Parese und Defektheilung sowie Patienten in der Regenerationsphase der akuten Parese sind digitale Trainingssysteme von Interesse. In der klinischen Praxis sind diese Programme jedoch noch nicht angekommen. Im Rahmen des vom BMBF geförderten IRESTRA-Projektes wurde eine Akzeptanzstudie durchgeführt (Altmann et al. 2017). Diese beschäftigte sich mit der generellen Technikakzeptanz sowie der Akzeptanz eines emotionssensitiven Trainingssystems von Patienten mit Fazialisparese und deren Angehörigen. Die Daten dieser Studie werden in der vorliegenden Arbeit weiter ausgewertet. Insoweit soll der Frage nachgegangen werden, was Prädiktoren der Technikkompetenz sind. Zudem soll geklärt werden, ob Zusammenhänge oder Unterschiede bezüglich verschiedener Nutzerpräferenzen und Patienteneigenschaften sowie Symptomen bestehen. Darüber hinaus soll die Rehabilitationsmotivation der Patienten mit Fazialisparese genauer untersucht werden, da die Motivation als Einflussfaktor auf den Erfolg einer Therapie gesehen werden kann (Hafen et al. 2001). Um diese Fragen zu beantworten, wurden die beantworteten Fragebögen von 81 Patienten mit Fazialisparese (Respondern) sowie die Daten von 204 Nonrespondern, welche zur Teilnahme an der Studie eingeladen wurden jedoch die Fragebögen nicht beantworteten, ausgewertet. Erhoben wurden die Fragebögen FaCE, PHQ-9, PSQI, SF-36, PAREMO, TA-EG, der Fragebogen zur Technikbereitschaft von Neyer et al., sowie soziodemografische Aspekte. Ferner wurden Fragen zu Symptomen, dem Verlauf der Erkrankung, zur Therapieteilnahme und zur Therapiebewertung gestellt und Nutzerpräferenzen bezüglich eines emotionssensitiven Trainingssystems erhoben. Zudem wurden der Sunnybrook Score, der Stennert Index, die erhaltenen Therapien und die Paresedauer zum Teil aus klinischen Akten ermittelt

On the Ethical Implications of Personal Health Monitoring

Recent years have seen an influx of medical technologies capable of remotely monitoring the health and behaviours of individuals to detect, manage and prevent health problems. Known collectively as personal health monitoring (PHM), these systems are intended to supplement medical care with health monitoring outside traditional care environments such as hospitals, ranging in complexity from mobile devices to complex networks of sensors measuring physiological parameters and behaviours. This research project assesses the potential ethical implications of PHM as an emerging medical technology, amenable to anticipatory action intended to prevent or mitigate problematic ethical issues in the future. PHM fundamentally changes how medical care can be delivered: patients can be monitored and consulted at a distance, eliminating opportunities for face-to-face actions and potentially undermining the importance of social, emotional and psychological aspects of medical care. The norms evident in this movement may clash with existing standards of ‘good’ medical practice from the perspective of patients, clinicians and institutions. By relating utilitarianism, virtue ethics and theories of surveillance to Habermas’ concept of colonisation of the lifeworld, a conceptual framework is created which can explain how PHM may be allowed to change medicine as a practice in an ethically problematic way. The framework relates the inhibition of virtuous behaviour among practitioners of medicine, understood as a moral practice, to the movement in medicine towards remote monitoring. To assess the explanatory power of the conceptual framework and expand its borders, a qualitative interview empirical study with potential users of PHM in England is carried out. Recognising that the inherent uncertainty of the future undermines the validity of empirical research, a novel epistemological framework based in Habermas’ discourse ethics is created to justify the empirical study. By developing Habermas’ concept of translation into a procedure for assessing the credibility of uncertain normative claims about the future, a novel methodology for empirical ethical assessment of emerging technologies is created and tested. Various methods of analysis are employed, including review of academic discourses, empirical and theoretical analyses of the moral potential of PHM. Recommendations are made concerning ethical issues in the deployment and design of PHM systems, analysis and application of PHM data, and the shortcomings of existing research and protection mechanisms in responding to potential ethical implications of the technology.he research described in this thesis was sponsored and funded by the Centre for Computing and Social Responsibility of De Montfort University, and was linked to the research carried out in FP7 research projects PHM-Ethics (GA 230602) and ETICA (Ethical Issues of Emerging ICT Applications, GA 230318)